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CHECKLIST FOR BIDDERS <br />oil 11 a a 6 <br />INI "71"01161*11111M W11 IN <br />LM 114-44M 1 RIG 11 X01 PrA &0A A It, I A; <br />Proper bid security included. The bidder has the option of providing either a Certified Check <br />X or Bid Bond. <br />Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely <br />X executed. <br />Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments <br />with Iran, Employment Eligibility Verification, Non -Discrimination Commitment and <br />X Certification of use of United States Steel Products or Foundry Products. <br />Proof of MBENVBE Participation Goal Form [MWBE-1.0]. If minimum participation goal is not <br />met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBEIWBE Contacted <br />X Form [MWBE-2.1]. <br />X All required additional information is included with the bid. <br />Proposal statements and other affidavits all signed by the proper party with name either <br />printed or typed underneath signature. <br />X This checklist submitted with the Bid. <br />MI'll- 1"M SIRRIMV011114 i <br />Bidder: Zillcowsld Constructionm Inc. Date: 9/22/2020 <br />Signature: <br />Print Name & Title: Kristin Kromcr, Contract Administrator <br />Version 4/2/2019 Contractors Bid for Public Works - 1 <br />